High (Ttg) Iga Test, Why Do Endoscopy?
Posted 19 November 2012 - 10:47 PM
Posted 20 November 2012 - 01:22 AM
As recently as four or five years ago no doctor would consider giving a celiac diagnosis on the basis of blood work alone, no matter the score. The endoscopy, the "gold standard", had to be done to confirm the diagnosis. And if you tested negative on biopsy you were usually told you were not celiac and you could eat all the gluten you wanted. You will still encounter many old school doctors who adhere to this protocol. Just as, apparently in your son's case, they ran only the tTG IgA, and none of the other celiac tests because celiac has always been considered a disease of the small intestine (only). We now know that is not true. And we now know that non-celiac gluten intolerance makes you feel just as bad as celiac; the jury is still out on what, if any, damage it does.
Part of the problem with the tTG is that there are other conditions which may elevate that score also (and as a matter of fact, there are other conditions that can cause damage to the villi in the small intestine, just to further complicate the picture, although celiac is more common.) This is one of the reasons why it is helpful to run the other tests in the celiac panel too, one of which, the DGP, is very specific to celiac.
One argument for doing the endoscopy is that it could uncover other unsuspected conditions. Many of our older members have found that they have h. pylori that they did not know about. Of course, the pill cam can do the same thing and I have no opinion one way or other about which would be the bettter option for you. The pill cam does traverse the entire intestine so reveals things that an endoscopy cannot. Whether or not either one of these is necessary really depends on you and your discussion with your doctor. It is ultimately your decision. But what you are looking for is a diagnosis that he can carry with him through school, so that special education plans can be put in place to protect him from gluten. Most schools require this in writing, and it even carries forward to meal plans in college. For an adult the diagnosis is not as important, apart from its effect on military service.
I hope this has been helpful and not just confused you further.
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Caffeine free 1973
Lactose free 1990
(Mis)diagnosed IBS, fibromyalgia '80's and '90's
Diagnosed psoriatic arthritis 2004
Self-diagnosed gluten intolerant, gluten-free Nov. 2007
Soy free March 2008
Nightshade free Feb 2009
Citric acid free June 2009
Potato starch free July 2009
(Totally) corn free Nov. 2009
Legume free March 2010
Now tolerant of lactose
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Posted 20 November 2012 - 08:14 AM
She was then scoped wtih a biopsy to diagnose Eosinophilic Esophagitus. More foods have to be removed from the diet as there are probably more "triggers". (gluten is a common "trigger" ) Research has now proven a link between Celiac and Eosinophilic Esophagaitus.
So having a scope done can show a proper, full diagnoses of Celiac and/or other disorders and give you a baseline of the amount of Celiac damage damage for comparison to recovery on a gluten free diet.
As my daughter's case she was (and is ) hospitalized on average once a year for dehydration or illness. Could the hospitalizations for the 3 years before the EE diagnoses have been prevented if we had Celiac and EE. diagnosed and treated?
Posted 20 November 2012 - 10:12 AM
As the other posters note, there are other potential causes for high ttg IgA levels, too.
We had a 6 week wait between when we found out our son had high ttg IgA levels (like your son's they were > 100) and when the endoscopy was scheduled. We used the time to test out some gluten-free recipes, so that after the procedure, the switch was easier to make.
Good luck with everything! Either way, I would put him on a gluten-free diet after the testing is done.
Posted 20 November 2012 - 02:10 PM
After his high test I got his siblings tested, and just got results - his brother S had a weak positive score (4) (4-10 is listed as a weak positive) and his Immunoglobulin was also high. (not sure how high, haven't seen the printout yet). Does anyone have any insight on how predictive that result is? I'm unclear what a high Immunoglobulin score means, any insight on that would be appreaciated. Thanks so much for your help!
Posted 24 November 2012 - 02:53 PM
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